RT Journal Article SR Electronic T1 CT Texture Analysis of Cervical Lymph Nodes on Contrast-Enhanced [18F] FDG-PET/CT Images to Differentiate Nodal Metastases from Reactive Lymphadenopathy in HIV-Positive Patients with Head and Neck Squamous Cell Carcinoma JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology DO 10.3174/ajnr.A5974 A1 Kuno, H. A1 Garg, N. A1 Qureshi, M.M. A1 Chapman, M.N. A1 Li, B. A1 Meibom, S.K. A1 Truong, M.T. A1 Takumi, K. A1 Sakai, O. YR 2019 UL http://www.ajnr.org/content/early/2019/02/21/ajnr.A5974.abstract AB BACKGROUND AND PURPOSE: Differentiating nodal metastases from reactive adenopathy in HIV-infected patients with [18F] FDG-PET/CT can be challenging because lymph nodes in HIV-positive patients often show increased [18F] FDG uptake. The purpose of this study was to assess CT textural analysis characteristics of HIV-positive and HIV-negative lymph nodes on [18F] FDG-PET/CT to differentiate nodal metastases from disease-specific nodal reactivity.MATERIALS AND METHODS: Nine HIV-positive patients with head and neck squamous cell carcinoma (7 men, 2 women; 29–62 years of age; median age, 48 years) with 22 lymph nodes (≥1 cm) who underwent contrast-enhanced CT with [18F] FDG-PET followed by pathologic evaluation of cervical lymph nodes were retrospectively reviewed. Twenty-six HIV-negative patients with head and neck squamous cell carcinoma with 61 lymph nodes were evaluated as a control group. Each lymph node was manually segmented, and an in-house-developed Matlab-based texture analysis program extracted 41 texture features from each segmented volume. A mixed linear regression model was used to compare the pathologically proved malignant lymph nodes with benign nodes in the 2 enrolled groups.RESULTS: Thirteen (59%) lymph nodes in the HIV-positive group and 22 (36%) lymph nodes in the HIV-negative control group were confirmed as positive for metastases. There were 7 histogram features (P = .017–0.032), 3 gray-level co-occurrence features (P = .009-.025), and 9 gray-level run-length features (P < .001–.033) that demonstrated a significant difference in HIV-positive patients with either benign or malignant lymph nodes.CONCLUSIONS: CT texture analysis may be useful as a noninvasive method of obtaining additional quantitative information to differentiate nodal metastases from disease-specific nodal reactivity in HIV-positive patients with head and neck squamous cell carcinoma.AUCarea under receiver operating characteristic curveHNSCChead and neck squamous cell carcinomaGLCMgray-level co-occurrence matrixGLGMgray-level gradient matrixGLNgray-level nonuniformityGLRLgray-level run-lengthHGREhigh gray-level run emphasisLGRElow gray-level run emphasisLRElong-run emphasisLRHGElong-run high gray-level emphasismaxmaximumRLNrun-length nonuniformityRPrun percentageSREshort-run emphasisSRLGEshort-run low gray-level emphasisSUVstandard uptake value